The study sought to assess the knowledge of adolescents regarding abortion in a selected area in Lagos Nigeria. The researcher used a non-experimental, exploratory, descriptive research design for the study. One hundred adolescents participated in the study. The study found that many adolescents will not admit to having had an abortion. Moreover, the respondents gave different meanings for abortion, had inadequate knowledge of abortion and sexual and reproductive health. Cultural taboos and religious beliefs have a great impact on adolescents’ sexual behaviour. Most adolescents would not access abortions services because they regard it as killing an innocent baby. Efforts should be strengthened to make contraceptives and family life education available and accessible to the adolescents. / Health Studies / Thesis (M.A. (Health Studies))

Background: In many developing countries, maternal deaths occur mainly as a result of unsafe abortions, a situation reflecting the inaccessibility of safe abortion services in such countries. In Ethiopia, unsafe abortion accounts for 32% of maternal deaths and almost 60% of gynaecological admissions, and is one of the top ten causes of general hospital admissions. Purpose: The purpose of this study was to assess the views of women about the accessibility of safe abortion services in governmental health centres. Methods: A quantitative cross-sectional descriptive and non-experimental study using structured questionnaires was conducted. 342 women who had received abortion care services in governmental health centres participated. Findings: 46.8% of the participants do not know about the penal code regarding safe abortion care. 52.9% of the participants viewed safe abortion care as inaccessible because there are various and competing factors which make abortion service to be viewed as accessible or inaccessible and these include distance to nearest health centre, the time it takes to receive the service, the cost of the service, and the lack of appropriate skills in the service providers. Conclusion: An improvement in the accessibility of abortion services will prevent deaths resulting from unsafe abortions / Health Studies / M.A. (Public Health)

Law / LL.M.

Text in Afrikaans / Summaries in Afrikaans and English / Hierdie studie toon dat vroue wat vir terminasie van swangerskappe aanmeld, se behoeftes wyer as bloot die verwydering van die fetus strek. Die diversiteit van probleme, vra 'n beradingsbenadering wat holisties van aard is. Indien die sosiale, psigiese en spirituele behoeftes nie aangespreek word nie, het ons in die holistiese hantering gefaal. Die Department Huisartskunde waar ek werksaam is, beywer hom vir 'n holistiese benadering van die pasient. Hierdie benadering word ook deur die huidige SuidAfrikaanse Regering onderskryf. Die vrou met die ongewenste swangerskap het 'n behoefte om, behalwe die fisieke probleme, in totaliteit verstaan en gehoor te word. Sy smag na 'n berader wat saam met haar deur die kompleksiteit van die probleem kan dink en voel. Die holistiese benadering behels die fisieke sowel as die psigiese, maatskaplike en spirituele behoeftes. Die studie het te doen met 'n soeke na 'n beradingsbenadering wat in al die behoeftesvan die vrou sal voorsien. / This study demonstrates that the needs of women requesting a termination of pregnancy extend much further than the mere removal of the foetus. The diversity of problems demands a counselling approach that is holistic in nature. We will fail in this holistic management, should the social, psychological and spiritual needs not be addressed. The Department of Family Medicine where I am employed strives towards a holistic approach to the patient. This approach is also endorsed by the present South African Government. The woman with an unwanted pregnancy needs to be heard and understood in totality, over-and-above the physical problem. She yearns for a counsellor who can think and feel through the complexity of the problem together with her. The holistic approach includes the physical, as well as the psychological, social and spiritual aspects. The study involves a search for a counselling approach which provides for all these needs of the women. / Philosophy, Practical and Systematic Theology / M.Th. (Praktiese Teologie - met spesialisering in Pastorale Terapie)

FILIPOVÁ, P. Abortion for underage people ? ethical context. České Budějovice, 2013. A diploma thesis written under Faculty of Health and Social Studies, the thesis advisor Mgr. et Mgr. Ondřej Doskočil, Th.D. The diploma thesis tries to describe the issue of abortion for underage applicants and related context. This sensitive issue is regulated by the Law no 66/1986, of abortion. The thesis is divided into theoretical and practical part. The first part deals with contemporary condition of abortion for underage people in general context. The following topics are analysed in the next step: historical context of abortion in the Czech Republic, relation of abortion and medicine, justificatory reasons of abortion and ethical context of this sensitive issue. Methods of abortion are described in the following section. One of the most crucial chapters is the consent and the steps which are taken in connection with underage patients. In the research part of the thesis, the strategy of qualitative research was used, which was performed by the method of interrogation. The semistructured interview was chosen as a technique for the interrogation. The research file consisted of 5 male and 3 female doctors from gynaecological surgeries and from the women department of hospitals from different parts of the Czech Republic. The aim of the diploma thesis was to describe the recent situation of providing consent about performing abortion of underage applicants for this medical intervention; to find out and describe how male and female doctors of gynaecological surgeries and women departments of hospitals deals with the whole abortion of underage people issue as professionals but also personally. The last of the generated aims was to point out ethical context connected with the issue on the basis of new-found information. In order to reach the aims mentioned above, we used a set of questions which were focused on the abortion for underage applicants procedure and on the issue of the consent about performing this medical intervention. In the discussion chapter, the answers from the interviews are summarized and those answers are compared with available literature and they are supported with arguments. In the end, thesis which can serve as hypothesis for possible quantitative research were defined. From the research, it came out that questioned male and female doctors prefer legal aspect of medical care when deciding at the expense of ethical aspects and they also notice a conflict between legal adjustment of abortion for underage people and legal adjustment of other medical interventions connected with this age group. It also came out that laws should origin from the deep conviction of the whole society because nobody cannot be sure how he or she would act in this situation. Interviewees emphasise that an underage girl should learn how to act with responsibility. If she feels mature enough for sexual life, she should also bear all the consequences of her decision. The thesis also refers to the question of the genesis of life as modern biology proves uniqueness of an individual from the moment of conception. Outcomes of the research could be used for description of the whole situation connected with abortion for underage people, for discovering this issue and extension of laymen and professional community awareness. The research could be also useful for helping professions.

Esta dissertação tem por objetivo analisar o aborto através da perspectiva da ética. Tentará responder algumas questões relacionadas à ética no aborto, as situações em que é eticamente permissível abortar, se o aborto é entendido como errado sempre ou existem situações em que se torna eticamente aceitável, além de questões relacionadas à personalização do feto. Questiona também a existência ou não, de danos ao conduzir uma gestação de um feto não desejado. Para construir a argumentação será utilizando o artigo de Thomson, publicado originalmente em 1971, e o de Schwarz publicado em 1992. A fundamentação será baseada na Bioética e no Utilitarismo, além da revisão das raízes históricas do aborto, da definição de pessoa e da possibilidade de definir quando começa a vida humana. / Submitted by Marcelo Teixeira (mvteixeira@ucs.br) on 2014-07-09T14:09:24Z No. of bitstreams: 1 Dissertacao Vera Lucia Mariani da Silva.pdf: 1429171 bytes, checksum: a745fce51e52fadbd27f6926470188d7 (MD5) / Made available in DSpace on 2014-07-09T14:09:24Z (GMT). No. of bitstreams: 1 Dissertacao Vera Lucia Mariani da Silva.pdf: 1429171 bytes, checksum: a745fce51e52fadbd27f6926470188d7 (MD5) / This essay has as main objective analyze the perspective trough ethics. It will attempt to answer some related questions about the abortion’s ethics, the situations where is ethically allowable the act of abortion, if the abortion is understanding as wrong ever or if could exist situations where abortions turns ethically allowable, also the questions related to the fetus as a persona. Likewise, questions the damage existences or not in conducting an unwanted fetus pregnancy. The argumentation’s building process is given utilizing the Thomson’s article originally published in 1971 and the Schwarz’s published in 1992. The substantiation will be based in Bioethics and Utilitarianism, in addition to, this essay review historical abortion’s roots, from the persona definition and the possibility of determine where human life begins.

Objetivo: Determinar la asociación entre apoyo social percibido y aborto inducido En mujeres jóvenes de centros maternos infantiles de Lima, Perú. Además, se estimó la prevalencia e incidencia de aborto inducido en esta población. Material y Métodos. Estudio transversal analítico en mujeres de 18 a 25 años de edad. Aborto inducido se evaluó a través de uno de los métodos de Rossier: diferencia del número total de embarazos terminados en aborto en y el número de abortos espontáneos, mientras que apoyo social percibido fue evaluado mediante la escala de DUKE-UNC. Se determinó la asociación entre las variables de interés ajustando por diversos confusores usando modelos lineales generalizados. Resultados: Un total de 298 mujeres fueron enroladas, con una edad media de 21.7 (DE: 2.2). El 43.6% (IC95%: 38.0%–49.3%) presentaba bajos niveles de apoyo social y 17.4% (IC95%: 13.1%– 21.8%) reportó por lo menos algún aborto inducido. La incidencia de aborto inducido fue de 2.37 (IC95%: 1.81–3.11) por cada 100 personas-año de seguimiento. Hubo evidencia de asociación entre el apoyo social percibido y aborto inducido (RR=1.93; IC95%: 1.13–3.30) después de controlar por potenciales confusores. Conclusiones: Existe evidencia de asociación entre bajos niveles de apoyo social percibido y aborto inducido en mujeres de 18 a 25 años. La incidencia de aborto inducido es igual o mayor que otros países donde el aborto es legal. Una gran proporción de mujeres tienen bajos niveles de soporte social. Se requieren estrategias para incrementar el soporte social de las mujeres y reducir las tasas de aborto inducido. / Objective: To determine the association between perceived social support and induced abortion among women from maternal health centers in Lima, Peru. Besides, prevalence and incidence of induced abortion were estimated in this population. Material and Methods: Cross-sectional study enrolling women aged 18 to 25 years. Induced abortion was defined using one of the Rossier methods: difference between the total number of pregnancies ended in abortion and the number of spontaneous abortions, whereas perceived social support was assessed using the DUKE-UNC scale. The association between variables of interest was estimated using generalized linear models adjusting by potential confounders. Results: A total of 298 women were enrolled, mean age 21.6 (SD: 2.2) years. Low levels of social support was found in 43.6% (95%CI 38.0%–49.3%) and 17.4% (95%CI: 13.1%– 21.8%) reported at least one induced abortion. The incidence of induced abortion was 2.37 (95%CI: 1.81–3.11) per 100 persons-year of follow-up. There was evidence of the association between social support and induced abortion (RR=1.93; 95%CI: 1.13–3.30) after controlling for potential confounders. Conclusions: There was evidence of an association between perceived social support and induced abortion among women aged 18 to 25 years. The incidence of induced abortion was similar or higher than countries where abortion is legal. A great proportion of women had low levels of social support. Strategies to increase social support and reduce induced abortion rates are needed.

Esta dissertação tem por objetivo analisar o aborto através da perspectiva da ética. Tentará responder algumas questões relacionadas à ética no aborto, as situações em que é eticamente permissível abortar, se o aborto é entendido como errado sempre ou existem situações em que se torna eticamente aceitável, além de questões relacionadas à personalização do feto. Questiona também a existência ou não, de danos ao conduzir uma gestação de um feto não desejado. Para construir a argumentação será utilizando o artigo de Thomson, publicado originalmente em 1971, e o de Schwarz publicado em 1992. A fundamentação será baseada na Bioética e no Utilitarismo, além da revisão das raízes históricas do aborto, da definição de pessoa e da possibilidade de definir quando começa a vida humana. / This essay has as main objective analyze the perspective trough ethics. It will attempt to answer some related questions about the abortion’s ethics, the situations where is ethically allowable the act of abortion, if the abortion is understanding as wrong ever or if could exist situations where abortions turns ethically allowable, also the questions related to the fetus as a persona. Likewise, questions the damage existences or not in conducting an unwanted fetus pregnancy. The argumentation’s building process is given utilizing the Thomson’s article originally published in 1971 and the Schwarz’s published in 1992. The substantiation will be based in Bioethics and Utilitarianism, in addition to, this essay review historical abortion’s roots, from the persona definition and the possibility of determine where human life begins.

O trabalho se propõe a compreender como as mulheres em situação de abortamento reconhecem o cuidado de enfermagem que o vivencia. Para tanto, a autora recorre à metodologia qualitativa utilizando a análise de conteúdo. Foram coletados depoimentos de treze mulheres hospitalizadas, em situação de abortamento, mediante as questões: "Como você reconhece o cuidado de enfermagem que está recebendo? Você pode descrever para mim?" Os discursos foram analisados e possibilitaram a construção de algumas categorias temáticas, que sinalizaram para o reconhecimento do cuidado de enfermagem e podem se constituir de subsídios para nortear a assistência à mulher, para que a sua situacionalidade e individualidade seja contemplada. Os resultados possibilitaram o reconhecimento de questões importantes ligadas à mulher que recebe o cuidado de enfermagem nessa situação, como um cuidado que deve levar em consideração o contexto de vida dessas mulheres, que envolve perspectivas e tabus, criando expectativas do cuidado que irão receber, envolto por preconceito, um cuidado no qual o biológico é priorizado o que pelas falas é insuficiente necessitando de um envolvimento genuíno dos profissionais e busca da integridade. Mostrouse também como um cuidado no qual há dificuldade na identificação dos profissionais e no qual o anonimato da equipe se faz presente. O reconhecimento desses aspectos abre novos caminhos para a assistência de enfermagem a essas mulheres no sentido de contemplá-las em sua totalidade. / This work aims at understanding how the women in the situation of abortion recognize the care of nursing which they have experienced it. For this purpose, the author used the qualitative methodology of using the analysis of the content. Thirteen women interviews were applied, while in abortion situation. The interviews were focused on the questions: "How do you recognize the nursing care that been assisting? Could you describe it to me?" The talks were analyzed and they enabled the creation of thematics categories that indicated the recognition from the care of nursing and may also provide guidelines for the development of assistance that would meet their specific needs. The results make possible the recognition of the important questions links of women who receive this care, which are considered their life contexts, which involves perspectives ands taboos, bringing up expectations about the care that they will receive, joined to prejudice. As the talks aren't enough for a biological care, there was a need for genuine involvement and search of entirety. It also showed that there's difficult to identify professionals and also that staff should be anonymous. The recognition of these aspects open up new ways completely to the nursing assistance.

Abstract Successful pregnancy is characterized by a shift toward Th2 type immune response and suppression of adaptive immune responses to ensure acceptance of the semi-allogenic fetal graft. Also the innate immune system plays a major role during pregnancy. Recurrent miscarriage is defined as three or more consecutive pregnancy losses. About 1% of all women will suffer recurrent miscarriage. The causes of recurrent miscarriage remain unexplained in half (50%) of the cases. Susceptibility to recurrent miscarriage is probably mediated by Th1 type immune response with pronounced expression and secretion of pro-inflammatory cytokines (e.g. TNFα and IFNγ) paralleled with decreased production of anti-inflammatory cytokines (e.g. IL-10). Factors that regulate immune response during pregnancy include hormonal factors (e.g. hCG and progesterone). Immunogenetic factors also contribute to this regulation. Several functionally important polymorphisms in various immunomodulatory genes have been identified during recent years. Some of these polymorphisms may be important in regulating the Th1/Th2 balance during pregnancy. Putative immune dysregulation caused by these polymorphisms has been researched intensively. Conflicting results have been published about associations between several of these polymorphisms and recurrent miscarriage. In this study, HLA-G (exon 2 and 3), IL-10 (-1082A/G), IL-1RA (intron 2 VNTR) and CD14 (-159C/T) polymorphisms were studied in 38 Finnish women with RM. All of these polymorphisms have been associated with altered gene expression. Distribution of HLA-G*I, II, III and IV were 0.577, 0.375, 0 and 0.048 respectively in the studied Finnish population. According to the present classification the G*I allele group mostly consists of the allele 010101, while G*II covers the combination of 010102, 010401 and 0105N, as well as some other rare alleles. There were no associations between recurrent miscarriage and the HLA-G, IL-10 and CD14 polymorphisms. However, in IL-1RA polymorphism, the rare IL1RN*3 allele was increased in women with recurrent miscarriage. It is not known, if this particular allele is associated with differences in IL-1RA or IL-1 production. Although the study population was small, it may be supposed that quantitative differences in the production of single immunomodulatory molecules due to normal genetic variation may not be grossly harmful to the fetal allograft. This indicates the robustness and flexibility of the reproduction system. For survival, it is essential that minor variations are tolerated. Thus, large-scale studies focusing on the effect of a pro-inflammatory genetic profile based on the presence of several pro/anti-inflammatory genetic markers are needed to discover if immunogenetic factors predispose women to recurrent miscarriage.